Meharry Medical College in Nashville secured its largest donation ever on Tuesday as part of a broader investment in physician training at historically black colleges and universities.

There are only four HBCUs with medical schools in the country. Bloomberg Philanthropies is investing in all of them. That will include a donation of $175 million to Meharry’s endowment. It’s part of an ongoing initiative to address systemic underinvestment in Black institutions.

One of Meharry’s missions is fighting racial health disparities. Dr. James E.K. Hildreth, the Meharry CEO, says making sure patients can seek care from providers with a shared cultural background is one of the ways it can further that mission.

“Mr. Bloomberg made the observation that these four schools contribute half of all the Black doctors in the country,” Hildreth said. “And if you think about there being 170 medical schools, that’s quite extraordinary.”

Health disparities measure preventable differences in health outcomes. For example, Black Tennesseans under 75 die from preventable causes at a rate 30% higher than white Tennesseans, according to the Robert Wood Johnson Foundation. Black women in Tennessee are 2.3 times more likely to die of pregnancy and childbirth-related causes than white women.

Racial health disparities have several causes, including barriers to health care and discrimination in health care settings.

Hildreth says the Bloomberg endowment investment could become a catalyst for even more donations. The university wants to transform how it trains future doctors — integrating more collaborative, hands-on instruction. That’s more expensive than the traditional classroom model.

“Higher education has been done the same way for more than 1,000 years, where you have a ‘sage on a stage’ lecturing to large groups of students,” Hildreth said. “And from my perspective, it’s a great way to teach, but it’s a terrible way to learn — at least for some students.”

Endowment boost

The $175 million investment is intended to keep the private medical school open for decades. Instead of going into something like a checking account, the money is going into an investment fund. The school will get to use some of the earnings off those investments every year, and the endowment’s value will continue to grow.

It is a more complicated type of gift, but there’s an upside: it’s more consistent.

“It really means sustainability,” Hildreth said. “That’s what endowments do for organizations. It also means that when challenging times occur financially, endowments help organizations to weather those challenging times.”

During tough financial times, it’s harder for donors to give. Enrollment can go down, taking tuition revenue with it. For public schools, state legislatures can cut back on the amount of money they put into higher education.

Endowments offer some protection.

Restoring generational wealth

The investment in medical schools is the most recent project under Bloomberg Philanthropies’ Greenwood Initiative, which aims to address systematic disparities in the U.S. and increase generational wealth for Black Americans.

It’s named for the neighborhood in Tulsa, Oklahoma. More than 100 years ago, it was one of the wealthiest Black communities in the country, earning the nickname Black Wall Street.

In 1921, white supremacists launched a two-day massacre on the district. Death estimates range from fewer than 40 to more than 300. Fire and explosions flattened 35 city blocks of Black-owned property. Greenwood soon became one of the poorest neighborhoods in the city with some of the worst health outcomes.

Meharry is one of several HBCUs in North Nashville. That neighborhood was also once thriving and wealthy.

In the 1950s and ’60s, U.S. transportation officials were designing and building highways, and often chose to route them through Black neighborhoods. That included North Nashville’s Jefferson Street corridor, which was divided to build Interstate 40.

More than 1,000 Black Nashvillians were displaced, according to an in-depth report by the Nashville Scene. The project destroyed 100 city blocks, an estimated 650 homes and 27 apartment buildings. The property that remained lost about a third of its value.

Like Greenwood, North Nashville went from thriving economically to being one of the poorest neighborhoods in the city. Compared to their neighbors in other parts of Nashville, residents experience worse health outcomes and more food insecurity.